• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.2
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• pp.105-115
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• 2005

Purpose: The lymph node status assessed by conventional histological examination is the most important prognostic factor in patients undergoing surgery for oral squamous cell carcinoma. The presence of lymph node metastasis has a strong adverse impact on patient survival even after extended radical resection. Despite these findings, tumour recurrence is not rare after surgery, even when histological examination shows no lymph node metastasis. Recently, molecular-genetically and immunohistochemically demonstrated micrometastasis to the lymph nodes has been shown to have a significant adverse influence on survival in patients with squamous cell carcinoma and histologically negative nodes. The present study sought to determine the incidence and clarify the clinical significance of molecular-genetically and immunohistochemically demonstrated nodal micrometastases and to correlate these data with the stage of oral cancer. Methods: Lymph nodes systematically removed from 71 patients who underwent curative resection between 1998 and 2003 with head and neck squamous cell carcinoma were examined molecular-genetically to detect cytokeratin 5 mRNA with RT-PCR and immunohistochemically to detect cells that stained positively for cytokeratins with the monoclonal antibody cocktail AE1/AE3. The postoperative course and survival rates were compared among patients with and without micrometastases, after numerical classification of overt metastatic nodes. Results: micrometastases were detected in 43(60%) of 71 patients by RT-PCR and 26(36%) of 71 patients by immunohistochemistry. By RT-PCR analysis, patients exhibiting a positive band for CK 5 mRNA had a significantly worse prognosis than those were RT-PCR negative. By immunohistochemistry, the presence of micrometastasis did not predict patient outcome. Conclusion: Micrometastases detected by RT-PCR may be of clinical value in identifying patients who may be at high risk for recurrence and who are therefore likely to benefit from systemic adjuvant therapy.

• Archives of Craniofacial Surgery
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• v.11 no.1
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• pp.53-57
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• 2010

Purpose: The radial forearm fasciocutaneous free flap is currently considered as the ideal free flap for reconstruction of mucosal and soft tissue defects of the palate. But the availability of stably attached oral and nasal mucosal lining is needed. In addition to this, for better operation field, operating convenience and esthetics, we planned a prelaminated radial forearm free flap. Methods: A 64-year-old male patient was admitted due to a $4{\times}4.5cm$ full through defect in the middle of the hard palate caused by peripheral T cell lymphoma with actinomycosis. In the first stage, the radial forearm flap was elevated, tailored to fit the hard palate defect, and then it positioned up-side down with split thickness skin graft. Two weeks later, the prelaminated radial forearm free flap was re-elevated and transferred to the palatal defect. One side covered with grafted skin was used to line the nasal cavity, and the other side (the cutaneous portion of the radial forearm flap) was used to line the oral cavity. Results: The prelamination procedure was relatively easy and useful. The skin graft was well taken to the flap. After 2nd stage operation, the flap survived uneventfully. There was no prolapse of the inset flap into the oral cavity and the cutaneous portion of the flap was mucosalized. The procedure was very successful and the patient can enjoy normal rigid diet and speech. Conclusion: The use of prelaminated radial forearm free flap for hard palate reconstruction is an excellent method to restore oral function. Based upon the result of this case, microvascular free flap transfer with prelaminated procedure is a valid alternative to the prosthetic obturator for palatal defect that provides an improved quality of life. It should be considered as an integral component of head and neck cancer therapy and rehabilitation.

• International Journal of Oral Biology
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• v.45 no.3
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• pp.107-114
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• 2020

Acacetin, which is present in damiana (Turnera diffusa) and black locust (Robinia pseudoacacia), has several pharmacologic activities such as antioxidant, anti-inflammatory, and anti-proliferative effects on cancer cells. However, the effect of acacetin on head and neck cancers has not been clearly established. This study aimed to examine the effects of acacetin on cell growth and apoptosis induction in FaDu human pharyngeal carcinoma cells. These were investigated by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay, Live/Dead cell assay, 4',6-diamidino-2-phenylindole dihydrochloride staining, caspase-3 and caspase-7 activation assay, and immunoblotting in FaDu cells. Acacetin induced FaDu cell death in a dose-dependent manner, with an estimated IC₅₀ value of 41.9 µM, without affecting the viability of L-929 mouse fibroblasts as normal cells. Acacetin treatment resulted in nuclear condensation in the FaDu cells. It promoted the proteolytic cleavage of procaspase-3, -7, -8, and -9 with increasing amounts of the cleaved caspase isoforms in FaDu cells. Acacetin-induced apoptosis in FaDu cells was mediated by the expression of Fas and activation of caspase-8, caspase-3, and poly (ADP-ribose) polymerase. Immunoblotting showed downregulation of the anti-apoptotic mitochondrial proteins Bcl-2 and Bcl-xL, but upregulation of the mitochondria-dependent pro-apoptotic proteins Bax and Badin FaDu cells after acacetin treatment. These findings indicate that acacetin inhibits cell proliferation and induces apoptotic cell death in FaDu human pharyngeal carcinoma cells via both the death receptor-mediated extrinsic apoptotic pathway and the mitochondria-mediated intrinsic apoptotic pathway.

• The Journal of Advanced Prosthodontics
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• v.8 no.5
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• pp.363-371
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• 2016

PURPOSE. On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages. MATERIALS AND METHODS. Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation). RESULTS. The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study. CONCLUSION. Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.8.2-8
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• 1982

Hoarseness is the change of voice quality which represents the abnormal function of phonation and is the main symtom of the laryngeal diseases. The etiology of hoarseness are known more than 50 causes, among them, viral upper respiratory infection is the main cause of hoarseness and the laryngeal nodule and polyp, laryngeal paralysis, laryngeal cancer, laryngeal papilloma and the laryngeal tuberculosis are the other causes of hoarseness in that order. Recently, the authors experienced 4 cases of uncommon etiology of hoarseness, so we present the cases with the brief review of literatures. Case 1. 29 years old male Admitted in Dept. of neurosurgery due to Traffic Accident. He had a trauma on the anterior neck. Hoarseness was developed on 1 month after the accident. Laryngoscopic finding; Paramedian paralysis of left vocal cord. Displacement of left arytenoid cartilage. Case 2. 53 years old male Admitted in Dept. of General Surgery due to Clonorchis Sinensis, under the general endotracheal anesthesia, Choledochostomy was performed. Laryngoscopic finding; Median paralysis of left vocal cord. Case 3. 56 years old male Admitted in Dept. of Internal Medicine due to Aortic Aneurysm. Hoarseness was developed on 3 months prior to admission. Laryngoscopic finding; Intermediated position paralysis of left vocal cord. Displacement of left arytenoid cartilage. Case 4. 74 years old male Admitted in Dept. of Internal Medicine due to Bronchogenic carcinoma. Hoarseness was developed on 3 years prior to admission. Laryngoscopic finding; Paramedian paralysis of right vocal cord.

• The Journal of Korean Academy of Prosthodontics
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• v.35 no.2
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• pp.330-343
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• 1997

Extraoral maxillofacial prostheses are essential for restoring facial structures that are lost as a result of congenital missing, injuries from accidents, surgical treatments of head and neck cancer. Recently, silicone is the most useful material for this purpose and is more advantageous than other maxillofacial prosthetic materials. However, there are some problems for long-term usage of silicone prostheses due to tear and color change. These are major contributing environmental factors to those problems that are such as ultraviolet light, cleansing agents, changes in humidity and successive adhesion and removal. The aim of this study is to evaluate the physical properties and color changes of maxillofacial prosthetic silicone material by those environmental factors using A-2186 silicone material (Factor II, USA) and two pigments, cadmium yellow medium and cosmetic red. Aluminium molds were fabricated according to the ASTM No. D412 & D624 specifications and resulted specimens from molds were fabicated and treated as follows. Control group and experimental I group were fabricated with 0.1% wt. pigment mixing in silicone elastomer and II-1 group, II-2 group of experimental II group were fabricated with 0.2%, 0.3% wt. pigment mixing in silicone elastomer, respectively. Control group was kept in darkroom at room temperature, I-1 group was kept under natural sunlight during 1week, I-2 group was soaked in 20% soap water during 1wk. I-3 group was successively adhered and removed 200 times on inner region of arm using Daro adhesive-33. Experimental II groups were kept in darkroom at room temperature. Instron universal testing machine was used to measure the % elongation, tensile strength, tear strength of control, experimental I, II groups and reflectance spectrophotometer(COLOR EYE-3000, Macbeth, USA) was used to measure the color differences between control group and experimental I group. The results were as follows : 1. When compared with control group, natural weathering group and 20% soap-water soaking group had no significant differences in % elongation(p>0.05). 2. 200 times successive adhesion and removal group, 0.2% wt. pigment group and 0.3% wt. pigment group had significant decreases in % elongation(p<0.05). 3. Natural weathering group, 20% soap-water soaking group and 200 times successive adhesion and removal group had no significant differences in tensile strength (p>0.05). 4. 0.2%, 0.3% wt. pigment groups had significant decreases in tensile strength(p<0.05). 5. Values of all experimental groups were decreased in tear strength. and 200 times successive adhesion and removal group had significant decrease in tear strength(p<0.05). 6. Natural weathering group and 20% soap-water soaking group had significant color differences(${\Delta}E$) and it could be detectable to naked eye(p<0.05). 7. Color differences between control group and 200 times adhesion and removal group were not detectable to the naked eye (${\Delta}E<1.0$).

• Journal of the Korean Society of Radiology
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• v.12 no.2
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• pp.209-216
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• 2018

In the field of angiography and interventional radiology, it is said that the risk of radiation exposure to the eyes is high due to the characteristics of work, but currently divided dose assessment and management are not carried out in reality. Therefore, in this study, in order to evaluate the dose of the operator in the surgical environment and to analyze the shields, firstly, we selected the point where the operator is mainly located, evaluated the exposure dose of the eye after attaching the pocket dosimeter to the lateral angle point of the head and neck phantom, and evaluate shielding effect when wearing lead glasses that is currently commercialized. Secondly, we evaluated the tendency of the exposure dose of the eye and the shielding effect through simulation in the same geometric structure as the actual measurement. As a result, in the case of measurement using a dosimeter, the cumulative dose increased with the increase of the fluoroscopic time, and the tendency was different according to the position of the operator. Simulation results show that the dose distribution of the eye lens in the mathematical phantom is about 1.1 ~ 1.3 times higher than that of the cornea. Also, The protective effect of the lead glasses showed a shielding effect of at least 3.7 ~ 21.4% in each eye.

• Journal of Biomedical Engineering Research
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• v.25 no.5
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• pp.343-349
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• 2004

Electroglottograph(EGG) is a signal recorded from the vocal cord vibration by measuring electrical impedance across the vocal folds through the neck skin. The purpose of this study was to develop EGG system and to evaluate possibility for the application on speech analysis and laryngeal disease diagnosis. EGG system was composed of two pairs of ring electrodes, tuned amplifier, phase sensitive detector, low pass filter, and auto-gain controller. It was designed to extract electric impedance after detecting by amplitude modulation method with 2.7MHz carrier signal. Extracted signals were transmitted through line-in of PC sound card, sampled and quantized. Closed Quotient(CQ), Speed Quotient(SQ), Speed Index(SI), fundamental frequency of vocal cord vibration(F0), pitch variability of vocal fold vibration (Jitter), and peak-to-peak amplitude variability of vocal fold vibration(Shimmer) were analyzed as EGG parameters. Experimental results were as follows: the faster vocal fold vibration, the higher values in CQ parameter and the lower values in SQ and SI parameters. EGG and speech signals had the same fundamental frequency. CQ, SQ, and SI were significantly different between normal subjects and patients with laryngeal cancer. These results suggest that it is possible to implement portable EGG system to monitor the function of vocal cord and to test functional changes of the glottis.

• Journal of the Korean Magnetics Society
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• v.25 no.6
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• pp.208-218
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• 2015

Recently, radiation therapy is used in the CT existing conventional two-dimensional radiation image, and set the size and location of the tumor in a manner that the image is going to change the treatment plan. After using the simulation using CT, radiation therapy it is four-dimensional or three-dimensional treatment made possible. and radiation therapy became the more effective ever before. High technology radiation therapy such as the treatment of SRS,IMRT, IGRT, SBRT, is a need to try contemplating the possibility to apply appropriate analysis and situation, so it has its own characteristics. and then it is believed that it is necessary to analyze and try it worries the proper applicability of the situation. The configuration of the various treatment that is applicable in many hospitals is necessary to try to determine how to practically apply the patients. Critical organs surrounding tumor give a small dose to avoid side effects and then the tumor has the therapeutic effect by providing a larger dose than before the radiation treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.3
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• pp.219-227
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• 2005

Purpose: Abnormalities in the p53 gene are regarded as the most consistent genetic abnormalities detected in head and neck squamous cell carcinogenesis. Two new members of the p53 gene family, p73 and p63 have recently been identified. They share considerable sequence homology with p53 in the transactivation, DNA binding, and oligomerization domains, indicating possible involvement in carcinogenesis. Disruption of the homeostatic balance between proliferation and apoptosis is widely believed to contribute to human oral carcinogenesis. The aim of this study was to analyze expression of p63 in squamous cell carcinogenesis and to compare with immunochemical markers representing cell proliferation and apoptosis. Materials and Methods: Using the Syrian hamster oral cancer model, the fraction of apoptotic (apoptotic index-AI), proliferating (mitotic index-MI) and p63 expressing keratinocytes were examined at normal, dysplastic and malignant oral epithelium using the TUNEL assay, PCNA and p63 immunostaining. Results: p63 significantly increased between normal and dysplastic epithelium and between dysplastic and malignant epithelium. PCNA significantly increased between normal and dysplastic epithelium and between normal and malignant epithelium. However, increase between dysplastic and malignant epithelium, though still increasing, was not statistically significant. The percentage of TUNEL positive cells increased from normal to dysplastic epithelium and returned to normal keratinocyte level in the malignant epithelium. However, differences between tissue types were not significant. The ratio of MI:AI increased significantly only in the dysplastic-malignant epithelial transition. The increase of p63 expression closely reflected the change in the MI:AI ratio during oral carcinogenesis. Conclusion: The p63 may be associated with the regulation of epithelial proliferation and apoptosis in DMBA-induced hamster buccal pouch squamous cell carcinogenesis. Further study is required to investigate which p63 isoforms are involved in hamster buccal pouch carcinogenesis.